Adopted Children

ABSTRACT The overwhelming majority of adoption studies have focused on adoptive parents' perceptions and feelings about post-adoption services and resources. Perhaps unintentionally, the adoption community has neglected the personal experiences of adoption told from the point of view of adopted children. This pilot study attempted to close this gap in the research literature by asking a sample of adopted children to describe their challenges vis-à-vis adoption, how they cope with such challenges, the barriers they encounter in seeking support, and what things they or someone else could do to help assist them. Concept mapping, an alternative methodological approach combining qualitative and quantitative strategies, was used to analyze the statements generated by the adopted children. Implications for future research on post-adoption service provision are discussed.

Based on the overall low rates of disruption, that is, removal of a child from an adopted home before legalization, adoptions are considered generally successful for many families (Barth & Miller, 2000). This is compelling, as many of these families may still be confronted with adoption-related issues that exert tremendous strain on their coping and adaptation abilities. A significant source of the stress for many families may be related to recent research that suggests that adolescent adoptees may be at an increased risk for behavioral and emotional problems compared to their non-adopted peers Sharma, McGue, & Benson, 1996a, 1996b. Brodzinsky (1993) presents a model, termed the stress-coping model, that addresses these issues in regards to adoption adjustment, and states that, "at the core of the model is the assumption that children's adjustment to adoption rests on their appraisal of, and efforts to cope with, a host of subtle, but pervasive, adoption-related losses" [italics added for emphasis] (p. 24). One positive aspect about this model is that it accounts for individual differences, such as biological predisposition and cognitive/developmental levels. Another is that it uses a systemic approach when discussing the coping strategies, such as social support networks, placement history, and other external resources. Nevertheless, the model primarily focuses on children that were adopted during infancy and only touches on the phenomena of special needs children adopted from the child welfare system. The current study will help fill this gap by presenting a beginning step to understand the views of such adolescent adoptees in regards to the key challenges they face as adoptees, how they cope with these challenges, the barriers they encounter when seeking to access supports, and how others can best assist them in this process.
While it is encouraging that a majority of adoptions are successful, research has shown that adoption disruptions are concentrated in adoptions of children with special needs, the same children that are overwhelmingly served by child welfare systems (Leung & Erich, 2002;Pinderhughes, 1998;Rosenthal, 1993a). Special needs is a term that varies from state to state, but typically refers to children that are more difficult to place through no fault of their own. Children with special needs include those adopted at an older age, with minority status, in sibling groups, with medical or developmental conditions, and children who have histories of child maltreatment, including physical, emotional, and sexual abuse and neglect (Smith & Howard, 1999).
This increased risk for adoption disruption among children with special needs seems to be concentrated among children adopted at older ages. Rosenthal (1993b) found that older child placements disrupt at rates between 10%-15%, ranging as high as 27%. A possible reason for these adoption disruption rates may be related to recent investigations that are suggesting that children adopted at older ages-many of whom have histories of child abuse and neglect and numerous foster care placements-are at a higher risk for more profound and enduring emotional and behavioral problems than children adopted at younger ages or infancy (Smith, Howard, & Monroe, 2000). The overall trend is a substantial increase in the number of special needs adoptions. In 1998, there were approximately 30,000 children adopted from the nation's public child welfare system who received a state or federal adoption subsidy (Child Welfare League of America, 2003a). As of September 30, 2000, that amount had increased to approximately 41,000 children adopted from the public child welfare system whose parents receive financial subsidies (Child Welfare League of America, 2003a). To ensure the placement stability and healthy growth and development of this increasing number of adopted children with special needs, a growing interest in the development and evaluation of post-adoption services has taken place.
Although post-adoption services have been available to some extent since the 1940s, research on the effectiveness of these services is considered to be in its nascent stage (Barth & Miller, 2000). Because empirical studies on the effectiveness of post-adoption services have been over-represented by methodological flaws including, but not limited to, small sample sizes, weak research designs, and non-random sampling, it can not be confidently stated that post-adoption services result in less disruptions or dissolution (Barth & Miller, 2000). This not withstanding, provision of post-adoption services is generally viewed as the best preventive approach to adoption disruption and, if not equally as important, eases the burden on adoptive families. It is therefore vital that the development and evaluation of post-adoption services continue so the strain on these families can be mitigated; thereby possibly minimizing the risk for disruptions.

POST-ADOPTION RESEARCH: PARENT FOCUSED AND CHILD NEGLECTED
The majority of the foregoing research on post-adoption services has focused on process variables, such as parents' perceptions of services received, parents' unmet needs, and program components. The results of many of these studies have suggested the need for developing better quality post-adoption services. For instance, in a comprehensive review of the adoption literature, Berry (1990) found that families adopting children with special needs claimed services to be insufficient. Similarly, among families adopting developmentally disabled children, Lightburne and Pine (1996) found post-adoption services to be underdeveloped to meet the needs of these families, and reported dissatisfaction by parents of the services they received. In their study of 562 parents who adopted predominately children with special needs through the child welfare systems, Rosenthal, Groze, and Morgan (1996) found that less than 27% secured post-adoption services, not including financial assistance and child counseling. Moreover, Rosenthal et al. determined that of those who had not received services, 33%-50% disclosed a need for services and that such services might have been helpful.
These discouraging findings have promulgated a number of quantitative and qualitative studies investigating parents' perceptions and feelings about post-adoption services and the resources of which they should be comprised. Moreover, considering post-adoption services are in their developmental stages and that there is no clear consensus on the particular services that they should entail, Barth and Miller (2000) posited that program planning of post-adoption services should "address the expressed needs of adoptive families" (p. 23). These studies have collectively shown that adoptive parents want specific services to help with raising their adoptive children. The post-adoption services sought by parents can be divided into three general areas: (1) educational and informational, (2) clinical, and (3) material services (Barth & Miller, 2000).
In stark contrast to the growing attention to adoptive parents, a significant gap in the literature indicates the neglect of the thoughts and feelings of adopted children and adolescents about post-adoption services-no less about adoption in general. Using a data base search guided by systematic research synthesis principles posited by Rothman, Damron-Rodriquez and Shenassa (1994), the present authors could find only one study conducted in the United States that considered adopted children and adolescents' perceptions and feelings about adoption. The study, conducted by Smith and Howard (1999), is a 4-year exploratory investigation of an adoption preservation program in Illinois that was designed to assist adoptive families at risk of adoption disruption or dissolution. A significant strength of this study was the combination of quantitative and qualitative methodologies, which added a level of richness and depth that is not realized with pure quantitative analyses.
As part of the qualitative methodology in the Smith and Howard (1999) study, two open-ended questions were asked of the children in regards to their perceptions about the best thing about being adopted and the hardest thing about being adopted (the number of children interviewed was not provided). Children most often stated that having a family, and the love and care that is inherent, is the best thing about being adopted. Sample statements capturing the essence of this category included, "You know your adoption parent loves you and wants you" and "Being special-having someone care about you and love you" (Smith & Howard, 1999, p. 50). On the other hand, the children most often reported the loss of their birth family as the hardest thing about being adopted. Sample statements highlighting the loss and grief of their birth parents included "Missing my birth mom" and "Not seeing my dad a lot" (Smith & Howard, 1999, p. 50). Children also identified challenges with the being labeled "different" or not feeling accepted by their peers or family. Sample statements reflecting this theme included "Worrying about fitting in" and "I'm sometimes afraid that if someone finds out you are adopted, they will make fun of you and treat you different from the others" (Smith & Howard, 1999, p. 50).
It seems that perhaps unintentionally, researchers have excluded the voice of the child and adolescent adoptee; thus neglecting the family experience of post-adoption services. If post-adoption service development can be guided by adoptive families' input, as Barth and Miller (2000) suggested, then it only seems reasonable that researchers should validate the concerns and needs expressed by adopted youth.
As part of a larger study focused on post-adoption service utilization in the State of Florida, information regarding different aspects of adoption and post-adoption services was collected from three groups: adoption professionals, adoptive parents, and adoptive children. The overall project goals included: assessing the barriers and obstacles to treatment and support service usage by post-adoptive families; identifying potential solutions to the barriers and/or obstacles identified by the three groups; and, making subsequent recommendations on methods to improve service utilization, availability, and accessibility based upon these findings (Ryan, 2001). The present study focused on the adopted children group. As a pilot study addressing the views of adopted youth, this study posed four research questions. First, what challenges do adoptive children have because they were adopted and how hard have these challenges been? Second, what things do adopted children do, or have support from, that help them with these challenges, and how helpful have they been? Third, what barriers sometimes get in the way of asking for or getting help and how hard is it to overcome the barriers? Fourth, what things can adopted children identify that they or someone else could do to get help and how easy is this to do? Neuman (2003) writes that, "A qualitative researcher analyzes data by organizing it into categories on the basis of themes, concepts, or similar features. He or she develops new concepts, formulates conceptual definitions, and examines the relationships among concepts" (p. 441). Concept mapping is such a methodological approach, designed for the management and interpretation of a specific type of qualitative data, that combines qualitative and quantitative analyses that utilizes a structured process, focused on a topic or construct of interest, involving input from one or more participants, to produce an interpretable pictorial view of their ideas and concepts and how these are interrelated (Trochim, 2001). The process of concept mapping involves a series of steps. The first step is to prepare the focal question or problem statement, and select the participants. The next step consists of having the participants generate the statements in response to the focal question. Once the statements are compiled, participants sort and rate the statements that are generated (as will be described further below). Once the data have been collected, they are analyzed statistically using the concept mapping technique, with the resulting concept maps computed. The final step in the concept mapping process is to utilize the maps to guide strategic planning. This process has been used in a wide variety of settings to tackle widely varying mental health topics and questions (Johnsen, Biegel, & Shafran, 2000).

Sampling
The contacts for this pilot study were derived from the State of Florida's list of parents receiving an adoption subsidy for a special needs child whom they had adopted. A total of 911 letters were sent to adoptive parents in three jurisdictions within the state (one in the Southern portion, one in the central portion, and the last in the Northern portion). The letters alerted parents that they may be contacted and invited to participate in the study, and that if they had a child twelve years of age or over he/she would also be invited to participate. This age cut-off point was chosen because it was felt that children younger than this may lack the cognitive sophistication to fully understand and complete the concept mapping tasks.
Using a systematic random sampling method, ten percent of families (n = 91) were contacted via phone. Of those contacted, fifty-six percent (n = 51) chose not to participate; with 44% (n = 40) of adoptive parents agreeing to complete the statement generation, and, of those, twelve chose to complete the subsequent sorting and rating portion of the study.
From those adoptive family participants described above, there were 17 children eligible where the parent generated statements. Of these, two were not able to participate due to cognitive disabilities; thus leaving 15 possible adopted child participants. Eight children chose to participate in the statement generation process, with four of these children continuing to complete the sorting and rating portion of the study.

Instruments/Data Collection
The interview consisted of demographic questions and the four focal research questions: (1) "Please describe three challenges that you have had because you were adopted"; (2) "Please describe three things that you do or supports you use (i.e., who do you talk to) to help with the challenges you have had being adopted"; (3) "Please describe three things that sometimes get in the way of asking or getting help"; and (4) "Please describe three things that you do or someone else could do to get help." The participant was asked to provide responses to each of the four focal questions. This format for collecting statements is an alternative to the focus group method that is commonly employed in the statement-generation portion of the concept mapping methodology. After the completion of the interviews, the response statements for each question were compiled and reviewed by the research team. Each member of the three person research team reviewed the statements for each question independently and screened out duplicate statements. The lists were subsequently compared. When total agreement occurred between the research team, the statement would be eliminated. In the event a unanimous count was not obtained (i.e., if only 2 of the 3 team members agreed to keep or discard an item) a discussion was undertaken. If consensus could not be reached, the statement was retained (a conservative, inclusionary stance was taken to retain as much information as possible, and to reduce any researcher bias). This process resulted in a final list of 41 qualitative statements-with all 11 statements for Research Question #1 retained, 12 of 15 statements for Research Question #2 retained, all 7 statements for Research Question #3 retained, and, lastly, all 11 statements for Research Question #4 retained. The statements were subsequently printed onto cards. For each of the four questions, a set of cards containing the specific question's statements for the sorting task, and one rating questionnaire per question were printed and given to each participant. The sorting and ratings tasks are described below.

Sorting
Each participant was provided with a set of cards for each of the four questions; each card contained one individual statement. Each participant was then asked to sort the statements for each question into conceptual piles that were meaningful to him or her. The last step in the sorting process was to have participants place each pile in an envelope provided. On the outside of the envelope, the participant was instructed to write a name depicting the concept represented by the statements contained in the envelope.

Rating
After the sorting task was completed, the participants were asked to rate each of the statements that were listed in a questionnaire format. Each of the total statements per research question was compiled into one rating questionnaire for that same question. The rating questionnaires to accompany each of the four research questions are, respectively, (RQ1) "How hard have these challenges been?"; (RQ2) "How helpful has this item been as a way to deal with the challenges you have faced?"; (RQ3) "How hard is it to get around this problem?"; and (RQ4) "How easy is this to do?" Each participant was asked to rate each statement contained in its respective ratings questionnaire for each the four research questions on a 7-point Likert response option, with 1 being not very, to 4 being somewhat, to 7 being very. Participants were instructed to rate all of the statements even if they had not experienced them.

Analyses
As stated previously, the data collected were subsequently analyzed utilizing the concept mapping technique (Concept Systems, 2003). The technique utilizes multidimensional scaling and hierarchical cluster analysis in order to derive a visual representation, or map, of the conceptual relationships among a set of qualitative statements. The concept map produced depicts clusters of statements, each ostensibly representing some underlying concept. In concept mapping, a multidimensional scaling analysis creates a map of points that represent the set of statements brainstormed, based on the similarity matrix that resulted from the sorting task. The hierarchical cluster analysis is subsequently conducted to represent the conceptual domain in concept mapping. This analysis is used to group individual statements on the map into clusters of statements that presumably reflect similar concepts. The end product is the cluster map, which shows how the multidimensional scaling points were grouped.
A bridging value ranging from 0 to 1 is also computed for each statement and cluster as part of the concept mapping analysis. The bridging value tells whether the statement was sorted with others that are close to it on the map or whether it was sorted with items that are farther away on the map. As an indicator of having been sorted with the same statement or group of statements most often, those statements with lower bridging values are purported to be better indicators of the meaning of the part of the map they are located in than statements with higher bridging values (i.e., those statements sorted with different statements by each participant). The program also computes the average bridging value for a cluster. Clusters with higher bridging values are more likely to "bridge" between other clusters on the map. Clusters with low bridging values are hypothesized to be more cohesive, easier to interpret, and reflect the content in that part of the map.
Lastly, the technique permits the researchers to specify the number of clusters desired in the solution. The minimum number of possible clusters is two, and the maximum is equal to one less than the total number of individual statements generated, with a default value of eight clusters. Ultimately, it is a qualitative judgment regarding the content of each cluster that decides the final cluster solution. After careful review of the various cluster options, the researchers then assign a name to each cluster, based on the statements included in the cluster, as well as the names given by the session participants.

Sample Characteristics
Interviews for the purpose of statement generation were completed with 8 children, ranging in age from 12 to 14. Of those who participated, there was an even gender split and a mean age of 13.8 years. Three children were Caucasian, three were African American, and two were listed as 'other.' Of the eight children, two had medical needs. Their parents rated the level of their special medical needs (on a scale from 1-10, where 1 = mild and 10 = severe) as a 1 for one child and 2 for the other. Five of the children had special behavioral needs (one of whom also had medical needs). Using the same Likert-type rating scale, the average for this group was 5.86 (SD = 1.65)-illustrating the challenging behaviors exhibited by several of these children. The remaining children were classified as special needs due to one or all of the following: adopted at an older age, member of a minority group, or adopted as part of a sibling group.
Four of the previous eight children participated in the subsequent sorting and rating process. The gender distribution of these children was evenly split. The mean age of this group was 13.5 years. Three of the four were Caucasian, and the remaining child was African American. Of these four children, only one had a special medical need (rated 2 out of 10). All four had special behavioral needs, with a mean of 6.25 (SD = 1.61).
Concept mapping findings generated from responses to the four interview questions are presented below. The findings are presented in two sections for each question. Short descriptive phrases to capture the concepts are offered and discussed. Each of the maps and analyses are presented for the adopted children. The first section identifies only the statements and how they were conceptually related by the adopted children. The second section provides the information on the way in which the adopted children rated the statements.
Question 1: Please describe three challenges that you have had because you were adopted.
There were 4 clusters identified from the qualitative statements obtained from the adoptive children participants as they responded to the focal question posed. Eleven unique statements were generated, with cluster sizes ranging from 1 to 4 statements. The clusters presented with bridging factors from a low of .12 to a high of 1.00. The following cluster names were either provided by the participants or were generated by the researchers based on the statements in the concept "piles": New Friends (.44); Family Integration (.12); Hard Times (1.00); and Outside Challenges (.35). The clusters and their respective statements are described below, and can be seen in Figure 1.
Cluster #1: New Friends (.44). The children in the study identified connecting with, and interacting with, new friends as an area in which they may experience challenges. This included having to make new friends after moving, as well as talking with friends about being adopted.
Cluster #2: Family Integration (.12). As evidenced by the low bridging number, this cluster is the most conceptually cohesive. The adopted children generally agreed that becoming part of a new family was challenging. The challenges identified in this cluster focused on adjusting to their new situation. Adjusting to their role within the family was also a challenge, as were learning the new family's rules. In addition, meeting and accepting the new family members as 'your' family was also a challenge.
Cluster #3: Hard Times (1.00). In spite of the high bridging factor, the general notion of this cluster is that losing someone close can be a difficult and challenging experience. Only one child verbalized a loss such as this, but all the children felt that this would be a difficult experience.
Cluster #4: Outside Challenges (.35). This concept highlights the challenges of dealing with outside hurdles. These primarily included issues pertaining to school (i.e., adjustments, catching-up, etc.) and medical problems 'that [

Rating of Question 1: How hard have these challenges been? (1 = not very to 7 = very)
Once the clusters were formed, the rating calculations were conducted to illustrate the variability felt by the adopted children in the level of difficulty assigned to each item. The cluster ratings ranged from 3.69 to 4.75, signifying that each of the clusters posed at least moderate difficulty. In Cluster #1, New Friends (average 4.25; range 4.00 to 4.50), the adopted children felt that it was somewhat hard to find a friend to talk with about their adoption experiences. Cluster #2, Family Integration (average 4.31; range 3.25 to 6.00), indicated that adjusting to being part of a new family was a very challenging task (6.00). In addition, accepting the new family as your own also scored as fairly hard (4.75). Cluster #3, Hard Times (4.75), had one statement regarding the death of a parent; however, this loss and its importance/difficulty was significant to all the respondent children-as evidenced by the fairly high score received. Finally, Cluster #4, Outside Challenges (average 3.69; range 2.75 to 5.00), identifies the difficulties experienced when 'adjusting to a new school' (5.00)-which was echoed in all the statements within this cluster.

Discussion of Question 1
The question above addressed the challenges and experiences that adopted children over the age of 12 have faced due to being adopted, as well as subsequently rating these items on their level of difficulty. The relatively high average of the total cluster solution (4.25) indicates the fairly difficult challenges that adopted children must face. These challenges include grieving the loss of their previous connections, as well as having to continually build relationships with the new family, new friends, new school and countless others. As such, it is clear that these challenges are life-long and not complete upon placement/finalization. Question 2: Please describe three things that you do or supports you use (i.e., who do you talk to) to help with the challenges you have had being adopted.
As shown in Figure 2, there were 3 clusters identified from the qualitative statements obtained from the adoptive children participants as they responded to the focal question posed. Twelve statements were generated, with cluster sizes ranging from 2 to 5 statements. The clus-ters presented with bridging factors from a low of .15 to a high of .82. The following cluster names were either provided by the participants or were generated by the researchers based on the statements in the concept "piles": School and Friends (.26); Support from Families (.82); and Trustworthy People (.15). The clusters and their respective statements are described below.
Cluster #1: School and Friends (.26). In response to the above focal question, adoptive children identified several avenues through which they have found help with the challenges they may face. This was a fairly 'tight' conceptual cluster, with two statements having a bridging value of 0.00. As such, 'participat[ing] in sports' and 'making new friends' were support outlets that were targeted by the adopted children. In addition, talking to the school counselor, a neighbor or peers were also found to be useful supports.
Cluster #2: Support from Family (.82). In spite of the high bridging factor, the general notion of this cluster is the support obtained from immediate family sources-such as siblings and parents. These sources may comprise the inner circle of the child's support system.

School and Friends
Trustworthy People

Support from Family
Please describe three things that you do or supports you use (i.e., who do you talk to) to help with the challenges you have had being adopted

FIGURE 2. Concept Map for Question #2
Cluster #3: Trustworthy People (.15). As evidenced by the low bridging number, this cluster is very conceptually cohesive. The adoptive children respondents repeatedly clustered statements regarding supports with whom to talk with together-and named them 'Trustworthy People.' Similar to the previous clusters, this cluster recognized the great importance of support from family and friends.

Rating of Question 2: How helpful has this item been as a way to deal with the challenges you have faced? (1 = not very to 7 = very)
After the clusters were created, the ratings for this question were computed to highlight the variability felt by the adoptive children for each item. The cluster ratings ranged from 4.50 to 6.38, thus signifying that each of the clusters has helped a moderate to great amount. In Cluster #1, School and Friends (average 4.50; range 3.00 to 6.00), adopted children suggested several sources of support, including formal (school counselor, organized sports) and informal (peers/friends, neighbors) sources. However, peers/friends appear to be the most significant source of support within this cluster-scoring an average of 5.63. Cluster #2, Support from Family (average 6.38; range 6.25 to 6.50), indicated a great amount of support found within the family system-with siblings scoring the highest. Lastly, Cluster #3, Trustworthy People (average 4.85; range 2.25 to 6.50), emphasizes the importance of making connections with individuals whom can be trusted, including friends (6.50), siblings (3.88) and parents (5.00). Overall, the impact of the adopted children's family and friends (i.e., the adopted children's natural helping network) was significant in supporting them as they face the many challenges often inherent in being adopted.

Discussion of Question 2
The question above asked adopted children which identified supports are the most helpful as they address the challenges faced through adoption. The supports highlighted by the respondents focused on school/ friends, family and trustworthy people; which closely parallels the domains of friends, family and special others identified by Zimet, Dahlem, Zimet, and Farley (1988) in their multidimensional scale of perceived social support. The cluster ratings for this question had an average of 5.24, signifying that, in totality, the adopted children garner much support from these sources. Informal supports, such as family and friends, were the most influential-scoring an average of 5.61. In contrast, for-mal supports' (school counselor, organized sports) average scored below the mid-point (3.38). As such, it is clear that these adopted children turn to their inner-system of supports (i.e., trustworthy people) when tackling an adoption-related issue. It is also important to note that none of the respondent children identified a specific adoption professional as a possible support source. This may be due to their previous adoption experiences. For example, it is not unusual to have numerous adoption professionals involved with the child prior to and, on occasion, after the adoption. Due to issues such as high adoption worker turnover, the lack of confidentiality due to the need to share pertinent information, etc., these potential support sources may not be seen by the adopted children as consistent or trustworthy. It is unclear if this is the cause, yet this phenomenon deserves further investigation if services to adopted children are to be sensitive to their needs.
Question 3: Please describe three things that sometimes get in the way of asking for or getting help. Figure 3 there were 3 clusters identified from the qualitative statements obtained from the adoptive children participants as  they responded to the focal question posed. Seven statements were generated, with cluster sizes ranging from 2 to 3 statements. The clusters presented with bridging factors from a low of .03 to a high of .91. The following cluster names were either provided by the participants or were generated by the researchers based on the statements in the concept "piles": People Not Understanding (.03); Busyness is Hard (.91); and Afraid to Ask! (.68). The clusters and their respective statements are described below.

As shown in
Cluster #1: People Not Understanding (.03). The adopted children responded that interacting with people that do not understand the experience of being adopted is a significant barrier. The tightness of this concept, as evidenced by the extremely low bridging factor, shows that all of the adopted children thought that this was an obstacle to using someone as a support. This is epitomized by the statement, 'It's hard to talk with friends about being adopted because they don't understand what it's like.' This sense of isolation through this experience, especially when 'people look [sic] down on you because of being foster care/adoption,' can be devastating.
Cluster #2: Busyness is Hard (.91). In spite of the high bridging factor for this cluster, the general notion is that being so busy with other tasks (either the adopted child or the support) makes connecting with the support difficult. For example, it was expressed that, 'Being so active that it's hard to find time to talk with people' and 'Father works a lot and that makes it hard to talk to him.' Thus, the competing 'pulls' of other tasks may interfere with the adopted child's ability to access needed support.
Cluster #3: Afraid to Ask! (.68). This cluster identified the feelings of fear that the respondent adoptive children face when attempting to get help. The title for this concept, as the previous one, was taken verbatim from the adopted children (including the exclamation point). This helps to illustrate the enormous barrier that is often faced when asking for help. One child was 'afraid to ask for help or to [have someone] spend time with you.' In addition, the adopted children were sometimes afraid to ask, for fear of making someone angry-which would subsequently sabotage their efforts to gain support.

Rating of Question 3: How hard is it to get around this problem? (1 = not very to 7 = very)
The ratings for this question were calculated to illustrate the variability felt by the adoptive children in the level difficulty in surmounting each item. The cluster ratings ranged from 4.13 to 5.00, signifying that each of the clusters posed at least a moderate obstacle to accessing support. In Cluster #1, People Not Understanding (average 5.00; range 4.25 to 5.75), adoptive children felt that the fear of people looking down on them (5.75) and the reactions from others due to their adoption (5.00) were the most difficult to deal with, and were significant barriers to using someone as a support. Cluster #2, Busyness is Hard (average 4.13; range 3.25 to 5.00), indicated being too busy, while being a barrier, is the least difficult to overcome. The adopted children recognize that it is easiest for them to find more time (3.25), but much harder for their parents (father) to work less and have the ability to spend more time with them (5.00). Lastly, Cluster #3, Afraid to Ask! (average 4.88; range 4.25 to 5.50), identified the level of difficulty in addressing the adopted children's fear of asking for help. The second highest statement of all (5.50) was the adopted children's fear of making someone angry when asking for help. Overall, it appears that the most difficult items were interspersed throughout the clusters-with fear being an over-riding factor (i.e., fear of others looking down on you, and fear of asking for help).

Discussion of Question 3
The question above addressed the level of difficulty associated with overcoming the barriers and obstacles to accessing support services. On average, the items were rated 4.67, which illustrates the moderate level of difficulty experienced overall across clusters. Numerous items were generated; although one theme was dominant-the difficulty experienced due to the fear of dealing with others surrounding adoption issues. As such, it is incumbent upon adoption professionals and adoptive parents to ensure that adopted children are allowed to ask for help and express their difficulties and problems within an open, patient framework. As the next question will show, there are avenues that can be taken to assist adopted children in overcoming this hurdle.
Question 4: Please describe three things that you or someone else could do to get help.
As depicted in Figure 4, there were 3 clusters identified from the qualitative statements obtained from the adoptive children participants as they responded to the focal question posed. Eleven statements were generated, with cluster sizes ranging from 2 to 5 statements. The clusters presented with bridging factors from a low of .25 to a high of .73.
The following cluster names were either provided by the participants or were generated by the researchers based on the statements in the concept "piles": Talking (.25); Working Out Ways to Be Together (.52); and Asking (.73). The clusters and their respective statements are described below.
Cluster #1: Talking (.25). In response to the above focal question, adoptive children thought that talking with others would help in overcoming the various barriers identified. Through talking and open communication, bridges could be built so that understanding could take place. The list of individuals to talk with were similar to the supports identified earlier, and included informal supports exclusively (i.e., friends, relatives, parents). In addition, there was an additional source listed-'talking to the Lord through prayer' which had a bridging factor of 0.00 illustrating the congruence of this support across the adopted children.
Cluster #2: Working Out Ways to Be Together (.52). In response to being too busy, the cluster solutions for working out ways to be together was created. The adopted children desired to find ways to spend more time with parents (father) and other family members. In addition, it was suggested that the children could engage their parents to take a more ac-

ADOPTION QUARTERLY
Working Out Ways to Be Together Asking Talking Please describe three things that you do or someone else could do to get help tive role in their activities, as well as finding common interests to build a relationship upon.
Cluster #3: Asking (.72). In spite of the high bridging factor, the general notion of this cluster is that to overcome the fear of asking for help, the adopted children can ask questions and work from smaller to larger things to gauge the level of receptiveness from the other party.

Rating of Question 4: How easy is this to do? (1 = not very to 7 = very)
Once the clusters were formed, the ratings were mapped to illustrate the variability felt by the adoptive children in their level of ease in implementing or acting upon each item. The cluster ratings ranged from 3.56 to 5.13 signifying that each of the clusters has at least moderate importance. In Cluster #1, Talking (average 4.35; range 3.00 to 6.75), adoptive children suggested talking with the various support sources to overcome the identified barriers. In particular, talking to the Lord through prayer (6.75) was a significant source of assistance in addressing the adopted children's feelings of fear and isolation. In fact, this often neglected area was rated as the leading method of coping with the obstacles to accessing help. Cluster #2, Working Out Ways to Be Together (average 3.56; range 2.00 to 5.00), indicated that finding common interests and building on them was the easiest way to overcome barriers. Cluster #3, Asking (average 5.13; range 4.25 to 6.00), emphasizes the importance of 'asking questions' (6.00) and building from smaller to larger requests to gauge the level of acceptance (4.25). Overall, communication (including prayer) and building relationships were viewed as important strategies.

Discussion of Question 4
The question above addressed the ways that barriers and obstacles to getting help can be overcome by the adopted children. On average, the entire cluster solution averaged 4.35, which illustrates the moderate level of ease needed to implement these actions. Overall, the adopted children need to be supported in their efforts to communicate with adoptive parents and adoption professionals so that the challenges listed earlier can be heard and adequately addressed. Lastly, the important role of prayer and spirituality as a coping mechanism must not be ignored. This may often be a source of support that has been utilized to help the child successfully traverse the many difficulties faced, and should not be diminished or under-valued.

IMPLICATIONS
As with all research, this study possessed several limitations such as that the participants in the child groups were drawn from the lists of families that receive adoption subsidies. In addition, of those children eligible to participate, only a relatively small percentage of parents would provide consent to speak with their children, and, as a result, no comparative groups of adopted children were possible. Lastly, it is generally accepted in research that the individuals who volunteer to participate may be different from those who do not. These data are not available to determine if the sample obtained is significantly different from the population of adopted children. Given these caveats, the findings cannot be generalized to all adopted children, or even to all adopted children with special needs. Thus, additional evaluation methods should be employed to gain a triangulated view of the importance and the needs that have been identified.
Due to the lack of test-retest reliability data available, the concept mapping findings represent a "snap-shot" of the situation as it was at the time of data collection, and, as such, data collected at other points in time may produce different statements, clusters, and/or ratings. These theoretical measures ask individuals to provide their subjective estimates of what has occurred in the past and what should occur, as opposed to what actually is or has happened. However, when assessing such supports, perceived support is often the most proximal feature utilized by an individual as to the level of supportiveness (Lazarus & Folkman, 1984). The basic assumption put forth by Lazarus and Folkman is that "people will have better adaptational outcomes if they receive or believe that they will receive social support when it is needed" [italics added for emphasis] (p. 259).
Detailed information and critiques regarding the utilization of bridging factors in the concept mapping technique are not in the literature; thus there is no generally held consensus as to what level (from 0-1) is considered acceptable at different levels of interpretation. Consequently, these bridging data should be viewed as a preliminary presentation to spur further discussion, as they may be suspect due to the small number of statements generated, as well as the small sample size. Bridging values may be influenced by both of these variables, as the frequency of statements being sorted together is dependent upon each (i.e., the more statements, the more opportunity for variability of cluster matches). Due to the nature of this pilot qualitative study, this limitation may make otherwise valid statements appear less so because the small num-ber of adopted child participants did not agree on the placement of some statements-even though all resultant clusters were rated as being somewhat (3.56) to very (6.38) important.
Despite these limitations, it is important to note that the professional literature regarding adoption does not reflect many attempts to include the views of children, but rather focuses primarily on parents (both birth and adoptive) and professionals in child welfare and mental health. It is a hope of the present authors that the three main implications reported here will serve as a catalyst for future research using the voices of adopted children: (1) support groups; (2) spirituality as a coping resource; and (3) family support and involvement.
The adopted children in this study reported three significant barriers towards asking for or getting help: people misunderstanding the experience of being adopted; insensitive remarks by others about being adopted; and fear of such reactions on the part of people as a repercussion of the social stigma that is associated with adoption. It is striking that these concerns are similar to those stated by the adopted children in the Smith and Howard (1999) study. Support groups may assist in decreasing the sense of stigma that is regrettably attached to their status as adopted children, help them realize that other children have similar questions, thoughts, and feelings, and enhance their self-efficacy and self-esteem (Smith & Howard, 1999). Perhaps the development of adoption support groups should not only be guided by professional opinion but by the expressed voices of those who will be the recipients of this type of intervention.
The adopted children and adoptive parents (in the parent segment of this study) identified spirituality as a strong coping mechanism used to mediate the challenges they encounter (second to family support) (Ryan, Glover, & Cash, in press). Although research investigating the role of religion as a supportive resource for families with adopted children with special needs is sparse, two long-term outcome studies (Erich & Leung, 1998;Glidden, 1991) have shown that such involvement (especially that of the mothers) was positively associated with higher levels of family health and possibly as an indicator of family cohesiveness. Given these preliminary findings, future research is needed to further explore the role this resource has for adopted children and their families. For instance, whether spirituality is a well-represented source of primary support among adopted children, whether it is practiced through formal religions, or through a "higher power" is unknown.
The adopted children expressed a yearning to spend more quality time with their families and a longing for more attention from their par-ents, most notably their fathers. Whether the adopted children felt similar feelings about their mothers was not explicitly acknowledged and cannot be inferred. The adoptive father's role in the development of the adoptive son (and daughter, we would argue) is imperative (see for example, Flynn, 2002). Baumann (1999) contends that "adoption professionals continue with the myth that adoption and adoptive parenting is primarily about mothering" (p. 379). The present authors concur with Baumann and hope that future research will advance our knowledge about the adoptive father/adoptive child relationship. Future research may investigate whether the gender of the adoptive child has an effect on what specific type of attention they desire from their adoptive father (and adoptive mother for that matter). Future research may also describe the types of activities adopted children enjoy doing with their families, what activities they would like to do with their families, and under what circumstances.
There may be a need for professionals and parents to implement methods for assisting children with grieving the loss of their previous connections. To illustrate, in a recent exploratory study on quantitative and qualitative data collected from 292 adopted children with various special needs, Smith, Howard, and Monroe (2000) found that grief associated with the loss of their previous parents accounted for the second most commonly identified emotional and behavioral issue confronting these children (second to separation/attachment conflicts). It seems that their parents could potentially-and should-help them with their grief through validating and being empathetic to their experiences. Yet, the adopted children conveyed a sense of fear in expressing their genuine feelings and thoughts to their family. The potential underlying explanations of this fear could not be inferred from the findings. As such, could it be that adoptive children are sensitive to the emotional states of their adoptive parents and wish not to hurt them with their own grief over their biological parents or previous placements? At the same time, could it be that adoptive parents are misidentifying the signs of grief from their adoptive children and consequently miss valuable opportunities to help them by providing timely emotional support-something that can ultimately enhance the bond between? Not only can future research address these questions, but also focus on developing efficacious interventions that can help adoptive parents with special needs adoptees cope with their grief and help adopted children to overcome their fears of asking for help.
Although this was a pilot project with several limitations, the findings yielded rich data that reflect the barriers and facilitators some adopted children have about seeking help. Future research investigations may address further the expressed concerns of adopted children about post-adoption issues. In addition to the suggestions for further research already described, a more representative sample of both adopted children with special needs and those without this label may provide for more commonality in the various challenges experienced and how these challenges may be overcome. Furthermore, the vast gap that exists between adopted children's perceptions and feelings about post-adoption concerns and needs and those of parents and adoption professionals may gradually begin to lessen with increasing validation of the voices of adopted children. To this end, more user-friendly post-adoption services, designed for the whole family-not just the parents-can be realized.